How Distressing is Attendance for Routine Breast Screening

A prospective cohort study of 2357 women eligible for participation in the UK National Breast Screening Programme was carried out to evaluate the immediate emotional and behavioural effects of attending for routine mammography. Women completed the Hospital Anxiety and Depression Scale (HADS) in the context of a survey by their General Practitioner before they knew they were to receive an invitation to attend screening and again at screening some 6 weeks later. In addition, an ad hoc Health Questionnaire was administered when the women attended for screening to assess possible self-perceived stress-related behaviour changes in the previous week.

2110 (89.5% response rate) women returned the initial postal baseline HADS and 1635 completed the HADS again at screening. Anxiety and depression scales were significantly lower at screening than at baseline (t = 3.16, p < 0.002, 95% CI = 0.07 to 0.31) and (t = 8.46, p < 0.0001, 95% CI = 0.32 to 0.52) respectively. Women scoring in the borderline range at baseline were more likely to move into the normal than the clinically significant range for anxiety (chi2 = 40.36, p < 0.001) and also for depression (chi2 = 56.04, p < 0.001), and women scoring in the clinically significant range for anxiety were more likely to become normal than vice versa (chi2 = 5.95, p < 0.02). The Health Questionnaire indicated that some women reported stress-related behaviour changes in the week prior to screening, especially those who were most anxious or depressed.